Prognosis of Patients with Breast Cancer Following Delayed Diagnosis During the COVID-19 Pandemic: A Real-World Cohort Study

Jae Pak Yi; Chang Ik Yoon; Su Hyun Lim; Hoon Choi; Se Jeong Oh; Hyobin Kim; Dae Sun Park; Jong Min Baek; Yong-Seok Kim; Ye Won Jeon; Jiyoung Rhu; Young-Joon Kang

doi:10.1245/s10434-024-16645-3

Prognosis of Patients with Breast Cancer Following Delayed Diagnosis During the COVID-19 Pandemic: A Real-World Cohort Study

Ann Surg Oncol. 2024 Dec 4. doi: 10.1245/s10434-024-16645-3. Online ahead of print.

Authors

Jae Pak Yi^#^{1

2}, Chang Ik Yoon^#³, Su Hyun Lim¹, Hoon Choi¹, Se Jeong Oh¹, Hyobin Kim¹, Dae Sun Park¹, Jong Min Baek⁴, Yong-Seok Kim⁵, Ye Won Jeon⁶, Jiyoung Rhu⁷, Young-Joon Kang⁸

Affiliations

¹ Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
² Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
³ Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
⁴ Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
⁵ Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
⁶ Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
⁷ Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
⁸ Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. [email protected].

^# Contributed equally.

PMID: 39633173
DOI: 10.1245/s10434-024-16645-3

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has globally impacted healthcare systems, delaying cancer screening, diagnosis, and treatment. South Korea experienced a 3-month lockdown during the peak of the pandemic, leading to postponements in breast cancer diagnosis and treatment. Although the pandemic's severity has decreased, addressing the treatment gap remains a concern.

Methods: This retrospective cohort study included patients diagnosed with breast cancer at five academic hospitals in South Korea during the pre-COVID (May-July 2019) and COVID (May-July 2020) periods. The primary endpoint was recurrence-free survival (RFS), and secondary endpoints included overall survival (OS), stage distribution, and age subgroup analyses.

Results: Among 716 patients (374 pre-COVID, 342 COVID), the 3-year RFS was significantly lower in the COVID group (88.3 vs. 89.7%, p = 0.030), while the 3-year OS was similar between groups (96.2 vs. 95.5%, p = 0.439). Age subgroup analysis revealed a significant RFS difference in patients under 65 years of age (p = 0.005) but not in those aged 65 years and older (p = 0.682). Stage distribution did not differ significantly between groups (p = 0.531).

Conclusions: The COVID-19 pandemic adversely affected 3-year RFS, especially among younger patients, despite no significant increase in advanced-stage distribution. Timely cancer screening remains crucial for young patients with fewer infectious disease complications.